<!-- toaster directive -->
<toaster-container toaster-options="{'position-class': 'toast-top-right', 'close-button':true}"></toaster-container>
<!-- / toaster directive -->

<!-- 导航条 -->
<div class="bg-white bread-crumb">
    <ul class="breadcrumb b-a m-b-n-xs lter b-b wrapper-md">
        <li><a ui-sref="main.tpl.homePage"><i class="fa fa-home"></i> 首页</a></li>
        <li><a ui-sref="main.plat.cooper.list" href="">合作申请</a></li>
        <li class="active" ng-bind="title"></li>
    </ul>
</div>

<!-- 内容区域 -->
<div class="wrapper-md content">
    <div class="panel panel-default">
        <!-- 头部 -->
        <div class="panel-heading font-bold">{{title}}
            <a class="btn btn-sm btn-icon btn-rounded btn-default pull-right m-t-n-xs" ui-sref="main.web.cooper.list"><i class="text-md fa fa-times text-muted"></i></a>
        </div>
        <!--表单-->
        <div class="panel-body">
            <form class="form-horizontal"  name="extract_form" id="form">
                <!--公司名称-->
                <div class="form-group">
                    <label class="col-lg-2 col-sm-3 control-label" for="companyName">
                     公司名称</label>
                    <div class="col-sm-6">
                        <input type="text" class="form-control" name="companyName" id="companyName" placeholder="请输入公司名称..." ng-model="record.companyName"  required>
                    </div>
                </div>
                <div class="line line-dashed b-b line-lg pull-in"></div>
                <!--公司网址-->
                <div class="form-group">
                    <label class="col-lg-2 col-sm-3 control-label" for="companyUrl">
                       公司网址</label>
                    <div class="col-sm-6">
                        <input type="text" class="form-control" name="companyUrl" id="companyUrl" placeholder="请输入公司网址..." ng-model="record.companyUrl"  required>
                    </div>
                </div>
                <div class="line line-dashed b-b line-lg pull-in"></div>
                <!--联系人姓名-->
                <div class="form-group">
                    <label class="col-lg-2 col-sm-3 control-label" for="person">
                       联系人姓名</label>
                    <div class="col-sm-6">
                        <input type="text" class="form-control" name="person" id="person" placeholder="请输入联系人姓名..." ng-model="record.person"  required>
                    </div>
                </div>
                <div class="line line-dashed b-b line-lg pull-in"></div>

                <!--联系方式-->
                <div class="form-group">
                    <label class="col-lg-2 col-sm-3 control-label" for="phone">
                       联系方式</label>
                    <div class="col-sm-6">
                        <input type="text" class="form-control" name="phone" id="phone" placeholder="请输入联系方式..." ng-model="record.phone" required>
                    </div>
                </div>
                <div class="line line-dashed b-b line-lg pull-in"></div>
                <!--Email-->
                <div class="form-group">
                    <label class="col-lg-2 col-sm-3 control-label" for="email">
                        Email</label>
                    <div class="col-sm-6">
                        <input type="text" class="form-control" name="email" id="email" placeholder="请输入Email..." ng-model="record.email"  required>
                    </div>
                </div>
                <div class="line line-dashed b-b line-lg pull-in"></div>

                <!--身份类型-->
                <div class="form-group">
                    <label class="col-lg-2 col-sm-3 control-label" for="type">
                        <span class="text-danger wrapper-sm"></span>身份类型</label>
                          <div class="col-sm-6">
                              <select class="form-control"  ng-model="record.type"  id="type" name="type" >
                                   <option value="1">广告主</option>
                                  <option value="2">媒体/开发者</option>>
                              </select>
                          </div>
                </div>
                <div class="line line-dashed b-b line-lg pull-in"></div>

                <!--需求描述-->
                <div class="form-group">
                    <label class="col-lg-2 col-sm-3 control-label" for="description">
                       需求描述</label>
                    <div class="col-sm-6">
                        <textarea class="form-control" name="description" id="description" placeholder="请输入需求描述..." ng-model="record.description"  ></textarea>
                    </div>
                </div>
                <div class="line line-dashed b-b line-lg pull-in"></div>


                <div class="form-group">
                    <label class="col-sm-1 control-label pull-right" style="padding-right: 40%;">
                        <a ui-sref="main.plat.cooper.list">
                            <button class="btn btn-default w-xs" ng-click="main.finance.extractApply.list">返回</button>
                        </a>
                    </label>
                </div>
            </form>
        </div>
    </div>
</div>